118 articles - From Friday Jan 24 2025 to Friday Jan 31 2025
Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…
| Gastroenterology |
|---|
AGA Clinical Practice Guideline on the Prevention and Treatment of Hepatitis B Virus Reactivation in At-Risk Individuals. This document provides updated guidance for the management of HBVr in at-risk individuals. Limitations and gaps in the evidence are highlighted. This guideline is expected to require updating in 5 years from publication. |
meta-analyses and systematic reviews
| Am J Gastroenterol |
|---|
Comparative Improvement in Health-Related Quality of Life with Advanced Therapies for Moderate-to-Severe Crohn's Disease: A Network Meta-Analysis. Advanced therapies were associated with improvements in HR-QoL after induction and maintenance. Upadacitinib 45mg and infliximab 10mg/kg ranked highest after induction and maintenance, respectively. |
| Endoscopy |
Prevention of bleeding after endoscopic resection of early esophageal neoplasia in patients with esophageal varices: a systematic review. ER appears to be a safe and effective treatment option in selected patients with concurrent early esophageal neoplasia and esophageal varices, provided that a tailored approach of adequate prophylactic measures is applied to prevent bleeding. |
| Hepatology |
Corticosteroids in severe alcohol-associated hepatitis? Not so fast: A systematic review of randomized controlled trials. We recommend taking up to a week to systematically and thoroughly evaluate patients before initiating steroids, and vigilant monitoring in the first month of treatment. We also recommend the lowest possible steroid exposure with a two-week steroid taper and close outpatient follow-up. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
|---|
Association Between Elevation of Serum Alanine Aminotransferase and HBsAg Seroclearance After Nucleos(t)ide Analog Withdrawal. ALT elevation after NA cessation is not associated with HBsAg seroclearance following NA withdrawal, suggesting cytolytic pathways are not essential for a functional cure. |
Chronic Use of Proton Pump Inhibitors Is Associated With Reduced 30-Day Mortality From Acute Pancreatitis. Compared to non-users, patients on chronic PPIs were older (p < 0.001) and had a higher Charlson Comorbidity Index score (p < 0.001). Mortality rates at 30 days were 1.5% in chronic PPI users and 4.6% in non-users (OR 0.33; 95% CI, 0.16-0.6; p < 0.001). |
Risk of Variceal Bleeding in Patients Receiving Atezolizumab-Bevacizumab Treatment for Hepatocellular Carcinoma. A low platelet count, main PVI, history of GI bleeding and VNT were significant risk factors for VB in patients receiving Atezo-Bev treatment for HCC. Identifying these factors can guide clinicians in assessing and managing VB risk in clinical settings. |
The Impact of Postoperative Prophylactic Medication on Long-Term Surgical, Severe Endoscopic and Endoscopic or Radiologic Recurrence Following Primary Ileocecal Resection in Patients With Crohn's Disease. Prophylactic medication following primary ICR significantly reduces long-term recurrence rates in CD and was identified as a protective factor for severe endoscopic and endoscopic or radiologic recurrence. |
| Am J Gastroenterol |
Cost-Utility Analysis of Non-Invasive Tests to Initiate Hepatocellular Carcinoma Surveillance in Metabolic Dysfunction-Associated Steatotic Liver Disease. Using FIB-4/VCTE to initiate HCC surveillance is cost-effective for MASLD patients. If VCTE is unavailable, FIB-4 alone is a cost-effective alternative for MASLD patients with diabetes or 3 metabolic traits. |
Fecal Calprotectin Correlates with Disease Extent but Remains a Reliable Marker of Mucosal Healing in Ulcerative Colitis. However, FC remained a reliable marker of mucosal healing across al disease extents, with AUC ranging from 0.878 to 0.915, and no significant differences between the extent categories (DeLong´s test, p ≥ 0.2919). FC showed a significant association with disease extent yet remained a reliable surrogate marker for mucosal healing across al disease extents. |
LONG-TERM PROGNOSIS OF NON-CELIAC ENTEROPATHIES AND A SCORE TO IDENTIFY PATIENTS WITH POOR OUTCOMES: A 30-YEAR MULTICENTER LONGITUDINAL STUDY. Mortality in NCEs is increased due to complications and lack of response to current therapies. We developed a clinical score to personalise follow-up. Targeted treatments are needed to improve outcomes. |
| Clin Gastroenterol Hepatol |
Gender-Equity Model for Liver Allocation using Artificial Intelligence (GEMA-AI) for waiting list liver transplant prioritization. The use of explainable machine learning models may be preferred over conventional regression-based models for waiting list prioritization in LT. GEMA-AI made more accurate predictions of waiting list outcomes, particularly for the sickest patients. |
| Endoscopy |
Clinician-reported Gloucester Comfort Scale scores underestimate patient discomfort and pain during colonoscopy: insights from comparison with a patient-reported experience measure. Clinician-reported GCS scores frequently underestimate the level of discomfort and pain as reported by patients. For accurate monitoring of patients' colonoscopy experience, the use of PREMs should be considered. |
Standard enhancement settings used on endoscopy systems significantly impair performance of artificial intelligence systems in endoscopy. This retrospective study indicates that performance of current endoscopic AI systems can substantially vary depending on the post-processing enhancement settings of the endoscopy unit. Specific data augmentation can mitigate this performance loss. |
Surveillance of primary sclerosing cholangitis - a comparison of scheduled or on-demand ERCP with annual MRI surveillance: a multicenter study. No differences were seen in liver-related deaths between the surveillance strategies. In this study comparing scheduled ERCP, annual MRI/MRCP surveillance, and on-demand ERCP, the strategy based on scheduled ERCP using individual risk stratification is associated with better overall prognosis and outcome. |
| Gastroenterology |
Non-contrast magnetic resonance imaging versus ultrasonography for hepatocellular carcinoma surveillance: A randomized, single-center trial. Non-contrast MRI is a better alternative to US for the surveillance of cirrhotic patients offering earlier stage at initial diagnosis and lower false-positive referral rate. ClincalTrials.gov, NCT02514434. |
| Gastrointest Endosc |
A Comparison of Endoscopic and Surgical Gastrojejunostomy in Patients with Malignant Gastric Outlet Obstruction: A National Cohort Analysis (2016-2020). Compared to surgical GJ, endoscopic GJ is associated with lower rates of peri-procedural adverse events, hospitalization charges, and length of stay. For these reasons, endoscopic GJ should be strongly considered in managing malignant gastric outlet obstruction. |
Gastroenterologists' Goals for Ergonomic Colonoscopes: Results of a National Survey. The colonoscope changes respondents prioritized were those pertaining to customizability for hand size and more easily manipulated control surfaces. Professional societies and industry should work together to design scopes more aligned with best ergonomic principles. |
Long-term outcomes after endoscopic eradication therapy for dysplastic and T1a adenocarcinoma related Barrett's esophagus: higher rate of late dysplastic recurrence with radio-frequency ablation monotherapy. The risk of IM, dysplasia and late recurrence is higher when RFA was the sole modality used to achieve CRIM, raising the possibility that RFA provides a less durable response. These findings may impact treatment and surveillance decisions. |
Outcomes of Anesthesia-Supported versus Endoscopist-Driven Sedation Modalities: A retrospective cohort study. These were substantially lower than the rates for other sedation groups, and odds ratios were significantly lower than 1.00 (p<0.05) in 30 out of 36 comparisons across procedural, sedative, and outcome categories. Sedation achieved with Midazolam/Fentanyl correlated with a lower rate of adverse events but significantly longer PACU LOS compared to Propofol, Propofol + Adjuvants, or General Anesthesia. |
Predicting the need for step-up after EUS-guided drainage of peripancreatic fluid collections, including Quadrant Necrosis Infection score validation: a prospective cohort study. The high-risk QNI group was associated with a significantly longer hospital stay (12 days vs 4 days, p=0.004). EUS tended to upscale the necrotic content compared to preprocedural Radiology (κ=0.31) CONCLUSIONS: The extent of necrosis and the QNI classification strongly correlated with the need for step-up and allocation to LAMS vs DPPS drainage, proposing a central role in treatment personalization. |
The effect of the timing of endoscopic detorsion on clinical outcomes in patients with sigmoid volvulus. There does not appear to be a clear correlation between a longer delay until endoscopic detorsion and worse patient outcomes, with only the length of hospitalization affected. This suggests that endoscopic detorsion need not always be performed urgently. |
| Gut |
In vitro microbiota model recapitulates and predicts individualised sensitivity to dietary emulsifier. Transplant of human microbiotas that the MBRA model deemed CMC-sensitive, but not those deemed insensitive, into IL-10-/- germfree mice resulted in overt colitis following CMC feeding. These results suggest that an individual's sensitivity to emulsifier is a consequence of, and can thus be predicted by, examining their baseline microbiota, paving the way to microbiota-based personalised nutrition. |
Glucocorticoid receptor suppresses GATA6-mediated RNA polymerase II pause release to modulate classical subtype identity in pancreatic cancer. Conversely, in basal PDAC ΔNp63 promotes Pol II recruitment and stabilises enhancer-promoter interactions. This study provides new insights into the transcriptional control and role of GR agonists in controlling PDAC molecular subtype identity. |
Low-coverage whole genome sequencing of low-grade dysplasia strongly predicts advanced neoplasia risk in ulcerative colitis. Within-LGD lesion genetic heterogeneity did not confound risk prediction. Measurement of CNAs in LGD is an accurate predictor of AN risk in inflammatory bowel disease and is likely to support clinical management. |
Predictors of response to low-dose amitriptyline for irritable bowel syndrome and efficacy and tolerability according to subtype: post hoc analyses from the ATLANTIS trial. These exploratory analyses demonstrate there are unlikely to be deleterious effects of amitriptyline in any particular IBS subtype and could help identify patients in whom amitriptyline may be more effective. |
Risk factors for pancreatic cancer in individuals with intraductal papillary mucinous neoplasms and no high-risk stigmata during up to 5 years of surveillance: a prospective longitudinal cohort study. IPMN size and its growth rate predict future pancreatic carcinoma risk only during first 5 years of follow-up. MPD diameter at 5 years may identify patients who still harbour a high risk for pancreatic carcinoma. |
| Hepatology |
Acute encephalopathy without hyperammonemia has a different presentation than overt hepatic encephalopathy and displays similarly severe prognosis. NonHep E accounts for one third of admissions for acute encephalopathy, and displays as severe prognosis as OHE. OHE is independently associated with lower transplant-free survival at one year. |
Clinical outcomes and care for spontaneous bacterial peritonitis: A national cohort study. The SBP bundle was associated with lower incidence of Stage 3 versus Stage 0-2 AKI (OR 0.66, 95%CI 0.51-0.86). Prospective implementation of evidence-based SBP bundles may improve care outcomes and mortality in SBP. |
Discovery of a MET-driven monogenic cause of steatotic liver disease. Eight of 45 (17.7%) individuals had predicted deleterious variants in the MET kinase domain confirmed to be functionally like the familial case variant. We report the first germline non-malignant rare MET-driven disease, a monogenic form of SLD. |
Identification of glycogen synthase kinase 3alpha/beta as a host factor required for hepatitis B virus transcription using high-throughput screening. Our recombinant HBV-based screening system enables the discovery of new targets. Using our approach, we identified GSK3 inhibitors as potential anti-HBV agents. |
PSC and colitis: A complex relationship. With this review, we aim to summarize the current knowledge on the gut-liver axis in PSC-IBD, provide new perspectives on risk stratification and treatment and identify gaps in our current knowledge. Our understanding of this complex relationship will therefore help to design clinical trials and shape the future therapy of PSC-IBD. |
Phosphoproteomics delineates hepatocellular carcinoma subtypes and pinpoints therapeutic targets. The corresponding drug, bosutinib, demonstrated efficacy in inhibiting the growth of subtype C tumors in liver cancer cell lines and HCC patient-derived xenograft (PDX) mouse models representative of the phosphoproteomic HCC subtypes. Our study provides a comprehensive exploration of the phosphoproteomic landscape of HCC, establishing new subtypes that match clinical features and identifying potential therapeutic targets for the most malignant C subtype. |
Short-term starvation boosts anti-PD-L1 therapy by reshaping tumor-associated macrophages in hepatocellular carcinoma. Modulating FBP1/Akt/Rab27a axis potentiates the anti-PD-L1 response using two liposomal delivery systems and macrophage adoptive transfer. This study describes the immunomodulatory effects of STS and provides a rationale for its application as an adjuvant in HCC immunotherapy. |
TIGIT-expression on natural killer cell subsets is an early indicator of alleviating liver inflammation following bulevirtide treatment in chronic hepatitis D. We here suggest that lacking the expression of the immune checkpoint inhibitor TIGIT on NK cell subtypes may be a hallmark of liver inflammation in HDV infection. BLV-therapy is associated with a reappearance of TIGIT on these cells, which may be one mechanism of why liver enzymes rapidly improve during therapy. |
| J Hepatol |
Contrast-enhanced ultrasound-based AI model for multi-classification of focal liver lesions. CEUS-based Model -DCB provides accurate multi-classification of FLLs. It holds promise to benefit a wide range of population, especially for patients in remote suburban areas who have difficulty accessing MRI. Impact and implications Ultrasound is the most common image examination for screening focal liver lesions (FLLs), but it lacks accuracy for multi-classification, which is the prerequisite for reasonable management. Contrast enhanced ultrasound (CEUS) offers better diagnostic performance, but highly relies on work experience of radiologists. We develop a CEUS-based model (Model -DCB ) can assist junior CEUS radiologists to achieve comparable diagnostic ability to senior CEUS radiologists and senior MRI radiologists. The combination of ultrasound device, CEUS examination and Model -DCB enables even patients in remote areas to obtain excellent diagnostic performance through examination by junior radiologists. Clinical trial NCT04682886. |
GRINA alleviates hepatic ischemia‒reperfusion injury-induced apoptosis and ER-phagy by enhancing HRD1-mediated ATF6 ubiquitination. Our study highlights the critical role of the GRINA-HRD1-ATF6 complex in regulating ER stress and autophagy during HIRI. These findings provide new insights into therapeutic strategies to alleviate HIRI. Impact and implications HIRI represents a multifaceted pathophysiological challenge commonly encountered during liver surgeries, yet its underlying molecular mechanisms remain inadequately understood. In this study, we revealed a significant negative correlation between GRINA levels and the severity of liver damage in patients with HIRI. Our findings demonstrate that GRINA alleviates endoplasmic reticulum stress by enhancing HRD1-mediated ubiquitination of ATF6, thereby maintaining calcium homeostasis and inhibiting ER-phagy. This study provides novel insights into the role of GRINA in protecting liver cells under HIRI, offering fresh perspectives for clinical prevention and management strategies for HIRI. |
Hepatocellular CMPK2 promotes the development of metabolic dysfunction-associated steatohepatitis. These findings establish CMPK2 as a critical mediator in the progression from metabolic dysfunction-associated steatotic liver (MASL) to MASH and highlight its potential as a therapeutic target for metabolic diseases. Impact and implications CMPK2 exhibits upregulated in the MASH stage but not in the early stages of MASLD. Our study demonstrated that diet-induced MASH phenotypes, including liver injury, inflammation, and fibrosis were alleviated in hepatocyte-specific Cmpk2-knockout mice. These findings suggest that CMPK2 serve as a critical link in the progression of steatotic liver to steatohepatitis, offering novel mechanistic insights MASH development. Furthermore, this discovery identified CMPK2 as a promising target for the development of therapeutic drugs for MASH. |
Prognostic performance of the two-step clinical care pathway in metabolic dysfunction-associated steatotic liver disease. Non-invasive 2-step approach by FIB-4 followed by LSM is effective in classifying patients at different risks of LREs. Impact and implications Metabolic dysfunction-associated steatotic liver disease (MASLD) is emerging as one of the leading causes of cirrhosis and hepatocellular carcinoma worldwide, but only a minority of patients will develop these complications. Therefore, it is necessary to use non-invasive tests instead of liver biopsy for risk stratification. Additionally, as most patients with MASLD are seen in primary care instead of specialist settings, cost and availability of the tests should be taken into consideration. In this multicentre study, the use of Fibrosis-4 index followed by liver stiffness measurement by vibration-controlled transient elastography effectively identified patients who would later develop liver-related events. The results support current recommendations by various regional guidelines on a clinical care pathway based on non-invasive tests to diagnose advanced liver fibrosis. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Aliment Pharmacol Ther |
|---|
| Clin Gastroenterol Hepatol |
| Gastrointest Endosc |
| Gut |
Metabolic dysfunction-associated steatotic liver disease in children. MASLD is a complex disease affecting one in ten children and is associated with increased early mortality risk. More dedicated studies are needed in children to advance our understanding of this disease and find effective treatments. |
| J Hepatol |
Radiation Segmentectomy for Early Hepatocellular Carcinoma is Curative. RADSEG method has evolved into an intra-arterial approach in this setting, with long-term outcomes comparable to ablation, resection, and transplantation. It is proposed that yttrium-90 radioembolization, applying RADSEG technique, be formally recognized as curative for early HCC. |
Update in Clinical Science: Autoimmune Hepatitis. This review is focused on developments from 2020 onwards so we can present a yet forward-looking view in the challenges and remaining questions necessary to improve patient care and outcome in AIH. We also outline areas of debate and offer insight into these areas. |
misc publications eg case reports, tools of the trade, images of the month, etc…
| Am J Gastroenterol |
|---|
| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastroenterology |
| Gastrointest Endosc |
| Gut |
| Hepatology |
| J Hepatol |
Letters to the editors and authors’ replies
| Aliment Pharmacol Ther |
|---|
| Gastroenterology |
| Gut |
| J Hepatol |